title: Cardiovascular events in subgroups of patients during primary treatment of hypertension with candesartan or losartan.
abstract: Merging data from existing electronic patient records, and electronic hospital discharge and cause of death registers, is a fast and relatively inexpensive method for comparing different treatments with regard to clinical outcome. This study compared the effects of antihypertensive treatment with candesartan or losartan on cardiovascular disease (CVD) using Swedish registers. Patients without previous CVD who were prescribed candesartan (n=7329) or losartan (n=6771) for hypertension during 1999-2007 at 72 Swedish primary care centers were followed for up to 9 years. Both medications were given according to current recommendations, and there was no difference observed in achieved blood pressures. The authors have previously shown that candesartan lowered the risk of all CVD (primary composite end point) more so than losartan (adjusted hazard ratio, 0.86; 95% confidence interval, 0.77-0.96). Candesartan also had a significantly better effect with regards to reducing the development of heart failure, cardiac arrhythmias, and peripheral arterial disease. In the present analysis, the authors found that candesartan, compared with losartan, reduced the risk of all CVD, irrespective of sex, age, previous antihypertensive treatment, baseline blood pressure, and presence of diabetes. These clinical findings may reflect differences between candesartan and losartan in their binding characteristics to the angiotensin type 1 receptor.
authors.affiliation: Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. david.russell@medisin.uio.no
authors.forename: David
authors.initials: D
authors.lastname: Russell
authors.forename: Jan
authors.initials: J
authors.lastname: Stålhammar
authors.forename: Johan
authors.initials: J
authors.lastname: Bodegard
authors.forename: Pål
authors.initials: P
authors.lastname: Hasvold
authors.forename: Marcus
authors.initials: M
authors.lastname: Thuresson
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002319:Cardiovascular System / Q000187:drug effects*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D053208:Kaplan-Meier Estimate; D019808:Losartan / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057216:Propensity Score; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013548:Sweden / Q000453:epidemiology; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; D019808:Losartan; C081643:candesartan